
Among 4468 people with HIV who initiated direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV) between 2014 and 2019, 91.7% achieved sustained virologic response (SVR4+) at least 4 weeks post-treatment. However, 5% experienced unsuccessful outcomes, defined by a positive HCV RNA test. Analysis revealed that CD4+ counts <200 cells/mm³ (aOR 1.81, 95%CI 1.00–3.29) and between 200 and 349 cells/mm³ (aOR 1.95, 95%CI 1.30–2.93) were associated with higher odds of treatment failure compared to counts >500 cells/mm³. Recent injection drug use showed a potential link to unsuccessful treatment (aOR 1.67, 95%CI 0.99–2.82), though not statistically significant. These findings underscore the need for targeted interventions for individuals with immunodeficiency and substance use to improve treatment outcomes.
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